# Development of a human placental extract for the prevention of necrotizing enterocolitis in premature babies

> **NIH NIH R44** · PLAKOUS THERAPEUTICS, INC. · 2021 · $769,983

## Abstract

PROJECT SUMMARY
Necrotizing enterocolitis (NEC), an acute inflammatory necrosis of the intestinal tract, is the most common
acquired gastrointestinal and surgical emergency for preterm very low-birth weight infants in the neonatal
intensive care unit. Despite considerable advances in neonatal care, NEC remains a devastating disease
(mortality rates range from 15% to 30%) that lacks a cure. Management is largely nonspecific and includes the
administration of broad-spectrum antibiotics, initiation of bowel rest and the provision of fluid and inotropic
support to maintain cardiorespiratory function. Surgical intervention is required in up to 50% of the NEC cases
and typically includes the removal of necrotic intestine. Normalizing the gut microbiome with antibiotics and
probiotics to remove the inflammatory and vascular toxicities caused by endotoxins in abnormal gut cultivars is
a popular recent treatment strategy. In addition, studies have shown that swallowed amniotic fluid is anti-
inflammatory, matures the fetal gut, and may prevent infection. Importantly, there are no treatments that mimic
amniotic fluid or its function in the fetal gut. Plakous has developed and patented methods to extract and
preserve the cytokines and growth factors stored within the placental disc. The result is an acellular
preparation of full-term, post-delivery human placenta that we have named Protego-PDTM. Our methods yield
high concentrations of chemokines with a much lower pro-inflammatory chemokine composition compared to
term amniotic fluid. We hypothesize that an orally administered therapeutic similar to 16-20 week amniotic fluid
during the transition between birth and normal feeding volumes will bolster and sustain gut maturation while
reducing the hyperinflammatory milieu which drives intestinal mucosal injury of the premature gut that
becomes NEC. Our preliminary data indicate that Protego-PDTM can increase gut cell number and
differentiation as well as modulate their response to lipopolysaccharides by decreasing TNF-α secretion. In
addition, Protego-PDTM has been shown to increase survival and decrease NEC incidence in a piglet model of
the disease. In this FastTrack SBIR, we propose to develop assays to ensure quality testing of our product,
assess dosing and safety profile examination in preparation for regulatory clearance. These objectives will be
accomplished through the following aims: 1) To develop a bioactivity assay to test the potency of Protego-
PDTM, 2) To evaluate Protego-PDTM efficacy and dose-response in a piglet model of NEC, 3) To evaluate the
safety of Protego-PDTM in a standard toxicology testing assessment in rodents. Successful completion of this
project will allow Plakous to put together an Investigational New Drug dossier necessary in the approval
process of a Biologic Therapeutic for Protego-PDTM. Additionally, the data will be presented to the Office of
Orphan Products to support the designation of Protego-PDTM as a therapeutic for N...

## Key facts

- **NIH application ID:** 10404156
- **Project number:** 4R44HD100243-02
- **Recipient organization:** PLAKOUS THERAPEUTICS, INC.
- **Principal Investigator:** Michael Bentley Berger
- **Activity code:** R44 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $769,983
- **Award type:** 4N
- **Project period:** 2021-08-01 → 2023-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10404156

## Citation

> US National Institutes of Health, RePORTER application 10404156, Development of a human placental extract for the prevention of necrotizing enterocolitis in premature babies (4R44HD100243-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10404156. Licensed CC0.

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